US NURSING SUPPLY IS AT A CRISIS

Nursing supply was already at a tipping point before the COVID-19 crisis.  The US was struggling to satisfy rising demand in the face of a decade-long and acute nursing shortage, which was projected to balloon to 200,000 unfilled positions this year.  The COVID-19 crisis has exasperated an already overwhelming shortage.

The HWRA is legislation that will increase the supply of nurses and doctors into the US.  These two occupations are among the shortest supplied occupations by US workers.

The US nursing crisis will only get worse:

• While the crisis is abating in some areas of the country, a COVID-19 vaccine is not expected for 18 months.  Spikes in infection rates will continue until the vaccine is developed.  
• CDC Director Robert Redfield fears that the virus’s continued assault on our nation next winter could “actually be even more difficult than the one we just went through.” He continued, "and when I've said this to others, they kind of put their head back, they don't understand what I mean." 
• Likewise, during the 1918 Spanish Flu pandemic some areas in the country did not reach their peaks until the following November.  The second wave was much more deadly than the first wave.
• Infection peaks have not yet happened in most of the country.  Seven of the eight counties with the most infections are all in New York.  While New York appears to have finally hit its peak, that state is an outlier.
• Other countries have not yet reached an infection peak.  As international travel comes back on line, it is expected that US infection rates will re-emerge.
• Maldistribution of healthcare workers means that grave nursing shortages exist in some localities and specialties.  For instance, employers of dialysis nurses have seen their national shortage triple in the just eight weeks.  New York area hospitals are offering pay rates at 2 to 4 times a nurse’s usual salary, in an effort to attract nurses from other areas of the country.
• Nursing schools are forcing rushed graduations in an effort to put nurses immediately onto hospital rosters.  States are even waiving licensing requirements in an effort to get as many healthcare workers to work as quickly as possible.
• We know based on the experience of other countries that the coronavirus is a caregivers' illness. In Italy's Lombardy region, one of the country's hardest-hit, as much as 10 percent of all nurses and doctors have been infected and placed in quarantine.  Italy is now desperately calling on retried healthcare workers to join their fight.

JUNE 2020 VISA BULLETIN: PROGRESS FOR PHILS AND WW EB-3; EB-1

The Department of State has just issued the June 2020 Visa Bulletin. This is the ninth Visa Bulletin of Fiscal Year 2020. This blog post analyzes this month's Visa Bulletin.

June 2020 Visa Bulletin

Table A: Final Action Dates -- Applications with these dates may be approved for their Green Card (Permanent Residency card) or Immigrant Visa appointment.

Employment- based	All Other	CHINA	INDIA	PHILIPPINES
1st	C	15AUG17	08JUN16	C
2nd	C	01NOV15	12JUN09	C
3rd	08NOV17	15JUN16	01APR09	08NOV17

MU Law Analysis

This was another eagerly anticipated Visa Bulletin.  The DOS moved the Philippines and Worldwide EB-3 ahead by 10 months, which is encouraging.  The Indian and Chinese EB-3 dates moved ahead one month, which is also a promising sign. It would not surprise us to see another big progression in the July Visa Bulletin, especially for the Philippines and Worldwide EB-3s. 

The EB-1 movements were also reassuring.  India EB-1 progressed 10 months.  China EB-1 advanced by a month.  The Indian and Chinese EB-2 dates also moved ahead, with India progressing by 10 days and China by one month.  These progressions could mean that more visa numbers flow down to other categories.

MU continues to believe that the State Department should be accelerating these dates at a faster rate and will need to aggressively accelerate the dates in the next few months in order to ensure that all visas are used in fiscal year 2020.  We have said this for several months.  Very few immigrant visas have been issued in the last 60 days because of the COVID-19 crisis. 

Conspiracy rumors are out there.  Some are speculating that the White House is interfering and illegally holding back progressions. The State Department did not include any comments at the end of the Visa Bulletin.  This lack of transparency from the State Department is feeding the speculation.  At the very least the State Department should explain how it expect to use this year’s full allotment of immigrant visas.

TWENTY HOUSE CO-SPONSORS ON HR 6788 (HWRA)

Everyone has been working hard to drum up support for the HWRA in the Senate.  We have not however forgotten about the House and bill HR 6788.  We are pleased to announce that the bill now has 20 co-sponsors in the House of Representatives. We continue to have a bipartisan mix of House members from both the Democrats and Republicans, which is the best way to advance this important legislation.

Rep. Cole, Tom [R-OK-4]*

Rep. Finkenauer, Abby [D-IA-1]*

Rep. Bacon, Don [R-NE-2]*   

Rep. Rose, Max [D-NY-11]   

Rep. Woodall, Rob [R-GA-7]  

Rep. Cox, TJ [D-CA-21]  

Rep. O'Halleran, Tom [D-AZ-1]   

Rep. Swalwell, Eric [D-CA-15]   

Rep. Yoho, Ted S. [R-FL-3]   

Rep. Khanna, Ro [D-CA-17]   

Rep. Meng, Grace [D-NY-6]   

Rep. Peters, Scott H. [D-CA-52]   

Rep. Moolenaar, John R. [R-MI-4]   

Rep. Stewart, Chris [R-UT-2]   

Rep. Brooks, Susan W. [R-IN-5]   

Rep. Blunt Rochester, Lisa [D-DE-At Large]   

Rep. Johnson, Eddie Bernice [D-TX-30]   

Rep. Hayes, Jahana [D-CT-5]  

Rep. Hartzler, Vicky [R-MO-4] 

Rep. Bishop, Sanford D., Jr. [D-GA]

FOURTEEN SENATE CO-SPONSORS ON HWRA S.3599

Everyone has been working hard behind the scenes to drum up support for the HWRA.  We are pleased to announce that the bill now has 14 co-sponsors in the Senate.  We continue to have a bipartisan mix of Senators from both the Democrats and Republicans, which is the best way to advance this important legislation. In addition to Sen. Perdue (R-GA), we have:

Cosponsor
Sen. Durbin, Richard J. [D-IL]*
Sen. Young, Todd [R-IN]*
Sen. Coons, Christopher A. [D-DE]*
Sen. Cornyn, John [R-TX]*
Sen. Leahy, Patrick J. [D-VT]*
Sen. Paul, Rand [R-KY]
Sen. Carper, Thomas R. [D-DE]
Sen. Lankford, James [R-OK]
Sen. Wyden, Ron [D-OR]
Sen. Rounds, Mike [R-SD]
Sen. King, Angus S., Jr. [I-ME]
Sen. Ernst, Joni [R-IA]
Sen. Moran, Jerry [R-KS]

HWRA HOUSE BILL FORMALLY INTRODUCED

Members Brad Schneider (D-IL), Tom Cole (R-OK), Abby Finkenauer (D-IA), and Don Bacon (R-NE) introduced the HWRA into the US House of Representatives on May 8, 2020.  This is the House version of Senate bill S. 3599.  As with the Senate co-sponsors, this is another strong, bipartisan group of Representatives who are doing right by US patients and valuing the contributions of hard-working immigrants.

If enacted, the HWRA would:

-Grant visas to doctors (15,000), nurses (25,000), and their families (unreserved);

-Exempt HWRA visas from the per-country cap;

-Instruct DHS and DOS to prioritize these visa appointments so that these fully-qualified nurses can enter the US as fast as their visa appointments can be scheduled; and

-Mandate that employers attest that these immigrants will not displace an American worker.

HWRA FORMALLY INTRODUCED AND ASSIGNED S.3599

Musillo Unkenholt is pleased to report that the Healthcare Workforce Resilience Act has been introduced into the Senate and assigned S. 3599.

The bill is up to six co-sponsors! 

Three Republicans: David Perdue (GA), Todd Young (IN), and John Cornyn (TX).

Three Democrats: Dick Durbin (IL), Chris Coons (DE), and Patrick Leahy (VT).

We expect to continue to grow this strong base of original co-sponsors.  We shortly will be announcing a companion bill in the House, with another impressive group of House members.

You may want to follow us on Facebook or Twitter for breaking news on this important bill.

MU on Facebook: https://www.facebook.com/MusilloUnkenholtLLC/

Chris Musillo on Twitter: https://twitter.com/ChrisMusillo  @ChrisMusillo

HEALTHCARE WORKFORCE RESILIENCE ACT FAQ

Musillo Unkenholt is pleased to report that the Healthcare Workforce Resilience Act has been introduced into Congress.  The HWRA is smart, positive legislation that will increasing the supply of nurses and doctors into the US.  These two occupations are among the shortest supplied occupations by US workers.  Musillo Unkenholt and the AAIHR have been working closely with these offices for the last two months, assisting congressional staffers in drafting this legislation.

This is our FAQ about the legislation.

How does this help nurses and doctors currently in retrogression?

If the HWRA becomes law, all nurses and doctors whose visa applications are currently retrogressed immediately become current.  Likewise, any nurse or doctor whose I-140 is filed any time before 90 days after President Trump’s Emergency Declaration on COVID-19 also receives a retrogression-free visa, although there is an overall quota of 25,000 for RNs and 15,000 for MDs. 

What is retrogression?

There are thousands of fully qualified nurses and doctors who have been approved for US green cards but who are not in the US because of “visa retrogression.”  “Visa retrogression” is when a fully qualified visa applicant has to wait for a visa to become available because the EB-3 visa category is oversubscribed.  Right now, fully qualified Philippine and worldwide nurses must wait four years for a visa appointment because of the visa retrogression.  Indian nurses and doctors have a twelve year wait.

This legislation prioritizes fully qualified nurses and doctors by utilizing a portion of the hundreds of thousands of visas that have been authorized by Congress but have gone unused.

Does this legislation add any visas into the quota?

No. This legislation does not add visas to the overall visa quotas.  Likewise, it does not take visas from any other occupation.

The HWRA uses visas that Congress had previously authorized, but had gone unused from 1992-2020. 

Can spouse and children also receive immigrant visas?

Yes.  Spouse and under-21 children obtain visas at the same time as the nurse.  They may also follow to join.  These family members do not count against the overall 25,000 RN and 15,000 MD visa quota.

Are these nurses qualified to work in the US?

Absolutely.  Before any nurse can enter the US, the nurse must have:

(i)          Passed the US nursing licensing exam;

(ii)   Graduated from a university that is equivalent to a US nursing school;

(iii)       Passed an English fluency examination; and

(iv)       A spotless overseas nursing license. 

What protections are there for US labor?

Before the visa is issued, the employer must attest that the foreign trained nurse “has not displaced and will not displace a United States worker.’’

HEALTHCARE WORKFORCE RESILIENCE ACT PROVIDES NEEDED NURSES FOR US PATIENTS

Musillo Unkenholt is pleased to report that the Healthcare Workforce Resilience Act will be introduced into Congress next week.  The HWRA is smart, positive legislation that will increase the supply of nurses and doctors into the US.  These two occupations are among the shortest supplied occupations by US workers.  Musillo Unkenholt and the AAIHR have been working closely with these offices for the last two months, assisting congressional staffers draft this legislation.

If the HWRA becomes law, all nurses and doctors whose visa applications are currently retrogressed immediately become current.  Likewise, any nurse or doctor whose I-140 is filed anytime before 90 days after President Trump’s Emergency Declaration on COVID-19 is also expected to have a retrogression-free visa, although there is an overall quota of 25,000 visas for RNs and 15,000 visas for MDs.  The legislation contains language asking the USCIS and Embassies and Consulates to expedite these petitions.  The HWRA admirably contains US worker protections, guaranteeing that no US worker is displaced.

The HWRA has a strong set of original co-sponsors in the Senate: Sens. Perdue (R-GA), Young (R-IN), Durbin (D-IL), and Coons (D-DE).  This is an impressive bipartisan set of Senators with decades of experience leading legislative initiatives. 

In sum, the HWRA, with respect to nurses, does the following:

-Allows all fully-qualified foreign-educated nurses to have their visas granted, if they are currently in the retrogression queue or file their I-140s within ninety days of the President’s Emergency Declaration; and

-Instructs DHS and DOS to prioritize these visa appointments so that these fully-qualified nurses can enter the US as fast as their visa appointments can be scheduled.